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Posterior lamellar keratoplasty for a case of pseudophakic bullous keratopathy
G R Melles1, F Lander, W H Beekhuis
1Rotterdam Eye Hospital, The Netherlands. melles@oogziekenhuis.nl
Purpose:
To describe a new surgical technique for posterior corneal transplantation.
Methods:
An elderly patient had painful, pseudophakic bullous keratopathy with low visual potential. Through a 9.0-mm scleral tunnel incision, a midstromal pocket was dissected across the cornea, and a posterior lamellar disk 7.0-mm in diameter, which consisted of posterior stroma, Descemet membrane, and endothelium, was excised. A similarly shaped donor posterior disk was implanted in the recipient opening without suture fixation, and the scleral incision was sutured.
Results:
Throughout the postoperative period, the posterior corneal transplant remained clear and in position. Three months after surgery, the "suture-in" astigmatic error was 3.5 diopters. Pachymetry measured 0.44 mm.
Conclusion:
Posterior lamellar keratoplasty may be a new surgical approach with which to manage corneal endothelial disorders.